Deakin Health Economics, Institute for Health Transformation, Deakin University, Burwood, Australia.
Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia.
J Med Internet Res. 2023 Jan 18;25:e38081. doi: 10.2196/38081.
There has been a rapid shift toward the adoption of virtual health care services in Australia. It is unknown how widely virtual care has been implemented or evaluated for the care of older adults in Australia.
We aimed to review the literature evaluating virtual care initiatives for older adults across a wide range of health conditions and modalities and identify key challenges and opportunities for wider adoption at both patient and system levels in Australia.
A scoping review of the literature was conducted. We searched MEDLINE, Embase, PsycINFO, CINAHL, AgeLine, and gray literature (January 1, 2011, to March 8, 2021) to identify virtual care initiatives for older Australians (aged ≥65 years). The results were reported according to the World Health Organization's digital health evaluation framework.
Among the 6296 documents in the search results, we identified 94 that reported 80 unique virtual care initiatives. Most (69/80, 89%) were at the pilot stage and targeted community-dwelling older adults (64/79, 81%) with chronic diseases (52/80, 65%). The modes of delivery included videoconference, telephone, apps, device or monitoring systems, and web-based technologies. Most initiatives showed either similar or better health and behavioral outcomes compared with in-person care. The key barriers for wider adoption were physical, cognitive, or sensory impairment in older adults and staffing issues, legislative issues, and a lack of motivation among providers.
Virtual care is a viable model of care to address a wide range of health conditions among older adults in Australia. More embedded and integrative evaluations are needed to ensure that virtually enabled care can be used more widely by older Australians and health care providers.
在澳大利亚，虚拟医疗保健服务的采用迅速普及。目前尚不清楚虚拟护理在多大程度上得到了实施或评估，以用于照顾澳大利亚的老年人。
我们旨在回顾评估针对各种健康状况和模式下的老年人群体开展的虚拟护理服务的相关文献，并确定在澳大利亚，从患者和系统层面来看，更广泛采用虚拟护理服务所面临的主要挑战和机遇。
我们对文献进行了范围界定式综述。我们检索了 MEDLINE、Embase、PsycINFO、CINAHL、AgeLine 和灰色文献（2011 年 1 月 1 日至 2021 年 3 月 8 日），以确定针对澳大利亚老年人（年龄≥65 岁）开展的虚拟护理服务举措。研究结果根据世界卫生组织的数字健康评估框架进行了报告。
在搜索结果的 6296 篇文献中，我们共确定了 94 篇报告了 80 项不同虚拟护理服务举措的文献。其中大多数（69/80，89%）处于试点阶段，目标人群为社区居住的老年慢性病患者（64/79，81%）。实施模式包括视频会议、电话、应用程序、设备或监测系统以及基于网络的技术。与面对面护理相比，大多数举措显示出相似或更好的健康和行为结果。更广泛采用的主要障碍是老年人群体存在身体、认知或感官障碍，以及人员配备问题、立法问题和提供者缺乏积极性。
虚拟护理是一种可行的护理模式，可用于解决澳大利亚老年人群体的多种健康状况。需要进行更深入和综合的评估，以确保虚拟护理可以更广泛地被澳大利亚老年患者和医疗保健提供者使用。
